Key result
Tombak smokeless tobacco is linked to lower platelet counts and impaired coagulation markers.
Why the study?
The study was conducted to investigate the influence of oral dipping of Tombak smokeless tobacco on prothrombin time, activated partial thromboplastin time, international normalized ratio values, and platelet counts in Sudanese users.
Does exposure to oral dipping Tombak Smokeless Tobacco affect the coagulation profile and platelet counts in adult males?
Cross-Sectional (n=200)
No
Does exposure to oral dipping Tombak Smokeless Tobacco affect the coagulation profile and platelet counts in adult males?
Chronic oral use of Tombak smokeless tobacco is associated with potentially adverse alterations in coagulation pathways and platelet counts.
Answers are grounded in this paper and cite their sources.
Tombak use may impair hemostasis; hypothesis-generating for bleeding risk and requires prospective confirmation.
The goal of this paper is to investigate the influence of oral dipping of Tombak Smokeless Tobacco (SLT) on prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio(INR) values, and platelet counts (PLTs), in Sudanese Tombak users. An analytical cross-sectional study was conducted at Kosti health insurance hospital, Sudan, in 2019. According to the inclusion and exclusion criteria, 100 adult users of oral Tombak for three or more years were chosen randomly as a study group. Another 100 matched healthy individuals who never used Tombak were randomly selected as a comparative group. Venous blood specimens were collected in ethylene diamine tetra-acetic acid (EDTA) containers for the PLT counts using the automated haematology analyser (Sysmex, Tokyo, Japan XK-21SYSMEX) and in trisodium citrate anti-coagulant containers for coagulation tests using a co-agulometer machine analyser. Our findings show a significant decrease in PLT count mean values in the Tombak users group (212.1 × 103/mm3 ± 74.3 × 103/mm3) compared with the non-taking Tombak group mean values (243.2 × 103/mm3 ± 83.0 × 103/mm3), (p < 0.006). Both PT and APTT were significantly prolonged in Tombak users (16.03 ± 1.22 s vs. 14.44 ± 0.557 s), p < 0.001 for PT, and (41.62 ± 7.28 s vs. 34.99 ± 4.02 s), (p < 0.001) for APTT. INR mean values were significantly longer in Tombak users (1.11 ± 0.096) vs. (1.07 ± 0.66; p < 0.001). Multiple linear regression analysis findings show a significant impact of the four investigated variables, including duration of taking Tombak, age, and frequency of taking Tombak per day (p < 0.001). In conclusion, using Tombak a Smokeless Tobacco (SLT) for a long period significantly affect Platelet counts and coagulation profile.
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Elkhalifa et al. (2022) conducted a cross-sectional in Healthy (smokeless tobacco users vs non-users) (n=200). Tombak Smokeless Tobacco vs. No Tombak use was evaluated on Platelet count (PLTs) (p=0.0006). Long-term exposure to Tombak smokeless tobacco was associated with a significant decrease in platelet counts and prolonged PT, APTT, and INR compared to non-users.
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